Kornimate/medical-research-clean huggingface dataset:
pharmacological predictors of successful cyclosporine acute gvhd prophylaxis in children undergoing hsct

Conditions: Acute-graft-versus-host Disease

Summary: the specific objectives of this study are: primary: 1)to determine the relationship between cyclosporine auc achieved prior to engraftment and severe agvhd (grade iii and iv) secondary: 1. to determine the relationship between individual concentration-time points achieved prior to engraftment and severe agvhd (grade iii and iv) 2. to validate the previously developed lss to determine cyclosporine auc after iv administration at steady state and 3. to describe the relationship between cyclosporine auc and individual concentration-time points achieved prior to engraftment and other hsct outcomes (clinically significant agvhd (grade ii to iv), hypertension, engraftment failure, relapse


Eligibility criteria:
inclusion criteria: * less than 18 years of age * undergoing allogeneic myeloablative hsct at one of the participating centres and * scheduled to receive cyclosporine for agvhd prophylaxis * minimum patient weight: * 6.4kg if \ 6 months old all patients or guardians will provide informed consent or assent as appropriate. initial contact will be made by a member of the patient's current care team. consent will be obtained by a co-investigator or the ctsu personnel. exclusion criteria: -receipt of voriconazole or posaconazole within 14 days of the first cyclosporine dose or at any time until engraftment

Keywords: cyclosporine acute graft versus host disease prophylaxis children haematopoietic stem cell transplant
updating deep learning algorithms for osa monitoring

Conditions: Obstructive Sleep Apnea; Obstructive Sleep Apnea-hypopnea

Summary: the objective is to enhance the reliability of the algorithm to match that of level 1 polysomnography by leveraging the diverse data obtained from level 1 polysomnography to refine the deep learning algorithm.

patients undergoing level 1 polysomnography are equipped with the cart-i plus device, for collecting polysomnography data alongside concurrent photoplethysmography (ppg) signals. the collected data is categorized into apnea, hypopnea, and normal segments based on the polysomnography results. utilizing the ppg and accelerometer (acc) signals from the cart-i plus, metrics such as sao2 (oxygen saturation), respiratory rate, heart rate (hr), heart rate variability (hrv), and body movement are calculated for each segment. these metrics, along with the ppg and acc signals, are then used to develop a deep learning model that classifies the segments into apnea, hypopnea, or normal. participants are divided into training and validation sets. the deep learning model is trained on data from the participants in the training set, and its performance is evaluated using the validation set. the algorithm is constructed using convolutional neural networks (cnn), recurrent neural networks (rnn), attention mechanisms, and other advanced techniques recognized for their efficacy in classification tasks, specifically for identifying apnea, hypopnea, and normal segments.

Eligibility criteria:
inclusion criteria: patients scheduled for level 1 polysomnography at a sleep center who meet all of the following criteria: * aged 19 years or older * have listened to and understood a thorough explanation of the clinical study and voluntarily agreed to participate exclusion criteria: * under 19 years of age * unable to collect normal signals during the pre-test or wearing of the cart-i plus device * refuse to participate in the clinical study * have cognitive impairments to the extent that they cannot understand the explanation of the clinical study and therefore cannot make a voluntary decision to participate (e.g., legally incompetent individuals)
safety and efficacy of low-intensity shockwave therapy for peyronie's disease

Conditions: Peyronie Disease; Penile Diseases

Summary: investigation of the effect of low-intensity extracorporeal shockwave therapy (eswt) for peyronie's disease (pd) via a single blind, sham-controlled, randomized clinical trial. investigators will not be blinded to group assignments, but penile curvature will be assessed from coded patient pictures by a blinded assessor.


Eligibility criteria:
inclusion criteria: * ≥18 years old male, * untreated peyronie's disease (excepted oral therapy) (wash out: at least 1 month), * single axis penile curvature in erection at 20 - 90 degrees at baseline, * dorsal or lateral penile plaque, * able and willing to perform eswt self-treatment under supervision, * able to understand and complete patient questionnaires, * having sign an informed consent form prior to any study specific procedure, * being covered by a national health insurance exclusion criteria: * congenital penile deformity, * hourglass deformity, * circumferential plaque, * septal or ventral plaque, * plaque that cannot be palpated during clinical examination, * previous intralesional injection for peyronie's disease, * severe erectile dysfunction (ehs \< 3), * current penile, malignancy, * previous penile surgery except for circumcision or condyloma removal, * previous pelvic radiation therapy, * anti-coagulant medication, except acetylsalicylic acid up to 100mg daily, * previous low-intensity focused shockwave therapy on penis, * any other condition that would prevent the patient from completing the study, as judged by the principal investigator, * being deprived of liberty or under guardianship.
corticosteroid injection as a predictor of outcome in carpal tunnel release

Conditions: Carpal Tunnel Syndrome

Summary: this study will investigate whether symptomatic improvement following carpal tunnel corticosteroid injection can be correlated to symptomatic improvement following carpal tunnel release and therefore serve as a prognostic indicator. clinical question: does response to corticosteroid injection in cts predict outcomes of surgical treatment? secondary questions: 1. can we confirm previous retrospectively collected data that a certain percentage of conservatively managed patients with steroid injection will avoid surgery, and that patients who undergo surgery will have better outcomes than those who do not. 2. are there differences between worker's compensation and non-worker's compensation patients with regard to the primary clinical question? 3. what are carpal tunnel release outcomes for the subset of patients with negative electrophysiologic studies? 4. what are the outcomes of patients who undergo carpal tunnel release vs. those who choose not to undergo carpal tunnel release? a prospective cohort design study is the appropriate study design in order to measure the association between a predictor (response to injection) and outcome (response to surgery).

carpal tunnel syndrome is a painful condition that is caused by compression of the median nerve in the wrist. symptoms usually are pain, weakness, or numbness in the hand and wrist, radiating up the arm. corticosteroid injections have been utilized in the conservative management of carpal tunnel syndrome for several decades. they have been shown to be relatively safe with a very low reported complication rate. recent efforts in the literature have shown they are efficacious for a majority of patients although their effects are usually transient. several studies have attempted to show a predictive value of corticosteroid injection with regard to who will ultimately benefit from carpal tunnel release. there is a trend towards positive predictability with several retrospective studies showing that patients who have a clinical benefit from steroid injection are more likely to have a successful outcome from carpal tunnel release. carpal tunnel release remains the definitive treatment option for carpal tunnel syndrome, and a clinical test which could give the practitioner and patient additional information regarding likelihood of successful outcome of surgery would be a valuable prognostic tool.

Eligibility criteria:
inclusion criteria: * patients with a clinical diagnosis of carpal tunnel syndrome * english speaking patients only exclusion criteria: * patients less than 18 years old * patients who are pregnant by patient report or intending to become pregnant during the study * patients unwilling or unable to return for follow-up visits prescribed by the study protocol. * patients who qualify for inclusion in the study, but refuse to participate. * patients with evidence of thenar atrophy on exam * patients with a diagnosis of peripheral neuropathy or other neuropathy. * patients with previous ipsilateral carpal tunnel injection or release.
hashimoto's thyroiditis in upper egypt

Conditions: Hashimoto's Thyroiditis

Summary: the aim of this study is to evaluate the pathological pattern, characteristic features, treatment, complications and prognosis of hashimoto's thyroiditis in upper egypt.


Eligibility criteria:
inclusion criteria: * all patients with hashimoto's thyroiditis, males or females, any age, at upper egypt . exclusion criteria: * patients with associated other thyroid pathology other than hashimoto's thyroiditis.
family members at increased-risk for developing inflammatory bowel disease

Conditions: Inflammatory Bowel Disease (IBD); Ulcerative Colitis (UC); IBD-unclassified (IBD-U); Indeterminate Colitis; Crohn's Disease Colon; Crohn's Colitis; Crohn's Ileocolitis; Crohn's Gastritis; Crohn's Jejunitis; Crohn's Duodenitis; Crohn's Esophagitis; Ulcerative Proctitis; Ulcerative Proctosigmoiditis

Summary: first-degree relatives of people with inflammatory bowel disease ("ibd," including crohn's disease and ulcerative colitis) have an increased risk for developing ibd themselves. this study will follow unaffected first-degree relatives (who do not have ibd) over time to understand if their behaviors, diet, and biomarkers for ibd can help predict who gets ibd and if ibd can be prevented in these high-risk individuals. participants will be asked once per year to complete a questionnaire and have their blood, stool, and urine collected. the anticipated length of the study (registry) is approximately 10 years or longer. parts of this study, such as the questionnaires and stool and urine collection, may be done from home, while other parts, such as the blood draw, will need to be done from massachusetts general hospital.


Eligibility criteria:
inclusion criteria: * ability to give informed consent * ability to complete all study visits and study-related procedures * ability to understand and complete study questionnaires * must have at least one first-degree relative with inflammatory bowel disease (crohn's disease, ulcerative colitis, or ibd-unclassified) * age ≥ 14 exclusion criteria: * individuals with existing diagnoses of inflammatory bowel disease (ulcerative colitis, crohn's disease, or ibd-unclassified) * evidence of clinical signs or symptoms of ibd, which will be identified on pre-screening interview with the study coordinator.

Keywords: inflammatory bowel disease ibd ulcerative colitis crohn's disease
a confirmatory study of kuc-7483 in patients with overactive bladder

Conditions: Overactive Bladder

Summary: to evaluate the efficacy and the safety of kuc-7483 in overactive bladder patients.


Eligibility criteria:
inclusion criteria: * patients with a symptom of overactive bladder for more than 6 months. * patients who meet the following condition during the 3-day bladder diary period. * the mean number of micturitions per 24 hours is ≥8 times * the mean number of urgency episodes per 24 hours is ≥1 time exclusion criteria: * patients who are diagnosed as stress urinary incontinence are predominant. * patients with urinary calculus, interstitial cystitis, or clinically significant urinary tract infection.

Keywords: overactive bladder frequency micturition urgency urge urinary incontinence oab
spectral dynamics and speech understanding by hearing impaired people

Conditions: Hearing Loss, Sensorineural

Summary: the purpose of this program of research is to understand the perception of the dynamic spectral properties of speech by hearing-impaired listeners, with the long-term goal of improving speech understanding by these individuals in adverse listening conditions. the proposed research compares the performance of normally-hearing and hearing-impaired listeners on measures of speech understanding in the presence of different types of signal distortion and speech understanding of signals with enhanced spectral dynamics. a computational model based on the amount of potential information available in speech will be used to quantify differences in speech intelligibility due to hearing status and stimulus characteristics.

this is a behavioral study of human auditory perception. each experiment in this study involves prospective data collection from three types of listeners. the experimental listeners will be people with sensorineural hearing loss and the control listeners will either be subjects with normal hearing or normal-hearing listeners for whom hearing loss will be simulated through the use of a spectrally-shaped broadband noise. the tasks of the subjects in this study involve either listening to synthesized sounds over earphones while seated comfortably in a sound-treated booth, and making responses indicating the subject's auditory perception of these sounds by touching specific areas on a touch-screen terminal; or, listening to recorded, acoustically modified syllables, words, or sentences over earphones and making responses indicating the subject's identification.

Eligibility criteria:
inclusion criteria: * individuals with hearing thresholds of 20 db hl or better at all octave frequencies between 250 hz and 4000 hz * or, individuals with bilateral sensorineural hearing losses with thresholds between 25 and 70 db hl and no losses greater than 70 db hl at frequencies of 4000 hz or below exclusion criteria: * a conductive hearing impairment or other otological pathology * hearing thresholds greater than 70 db hl at any frequencies of 4000 hz or below or pure-tone averages (averaged across 500, 1000, and 2000 hz) of greater than 65 db hl * bilateral differences greater than 20 db at any frequency below 4000 hz * an inability to complete the experimental tasks

Keywords: hearing hearing loss, sensorineural speech perception
evaluating a host-response based diagnostic for distinguishing between bacterial and viral etiology in patients with lower respiratory tract infection (lrti)

Conditions: Lower Respiratory Tract Infection; Acute Bronchitis; Pneumonia; Chronic Obstructive Pulmonary Disease (COPD); Upper Respiratory Tract Infection

Summary: the purpose of this study is to validate the diagnostic accuracy of a novel host-response based diagnostic tool for differentiating between bacterial and viral etiologies in adult patients aged 18 years and older with clinical suspicion of lower respiratory tract infections (lrti)


Eligibility criteria:
inclusion criteria: * patients aged 18 years and older who agree (or their legal guardian agree) to sign an informed consent will be eligible for inclusion. * the lrti cohorts should also fulfill the following criteria: * peak measured (not tactile, self-reported acceptable) temperature ≥ 37.8°c (100°f) within the last 7 days (and) * symptoms duration ≤7 days (and) * clinical suspicion of lrti or pneumonia exclusion criteria: * oral/intravenous/intramuscular antibiotic treatment of over 48/12/12 hours' duration at time of enrollment (respectively), unless temperature ≥ 37.8°c was measured within the last 2 days * another episode of an acute infection during the last 2 weeks * congenital immune deficiency (cid) * a proven or suspected human immunodeficiency virus (hiv)-1, hepatitis b virus (hbv), or hepatitis c virus (hcv) infection * active malignancy * pregnancy * current treatment with immune-suppressive or immune-modulating therapies including without limitations: * use of high dose steroids \>1 mg/kg/day prednisone or equivalent in the past two weeks * monoclonal antibodies * intravenous immunoglobulin (ivig) * cyclosporine, cyclophosphamide, tacrolimus * granulocyte/monocyte colony stimulating factor (g/gm-csf) * anti-tumor necrosis factor (tnf) agents * interferon (of all kinds) * other severe illnesses that affect life expectancy and quality of life such as: * moderate to severe psychomotor retardation * post-transplant patients (including solid organs, allogeneic/autologous stem cell transplantation) * moderate to severe congenital metabolic disorder
cost effectiveness analysis of cholecystectomy, projected long term outcomes and complications evaluation

Conditions: Cholelithiasis

Summary: participation in this research study does not involve any procedures. health preference will be ascertained through standard techniques including time-tradeoff, standard gamble, and rating scale to assess risks regarding potential complications specific to notes (natural orifice translumenal endoscopic surgery)gallbladder removal.

the enticement of scarless surgery has created an unprecedented wave of enthusiasm and collaboration amongst surgeons, gastroenterologists, industry, and the lay public. however, major hurdles remain between current minimally invasive practices and the ultimate goal of safe, effective natural orifice translumenal endoscopic surgery (notes). in an ideal world, these procedures should incur equivalent (or less) morbidity than current laparoscopic approaches and offer benefits of incisionless surgery. this idealism has been quickly tempered by the potential to create new and devastating complications with only minimal potential benefit to the patient. several critical questions need to be answered. what probability of complication(s) are to be accepted? how will the potential benefits of notes be weighed against these new complications? what factors unique to notes will contribute to its cost effectiveness? the proposed study seeks to answer these questions before they occur. these results will give clinicians and investigators the necessary information with which to compare outcomes of notes and potentially alter techniques for safer, more effective interventions.

Eligibility criteria:
inclusion criteria: * candidate of either sex * 18 years old or above * have symptomatic cholelithiasis * wish to undergo laparoscopic cholecystectomy for treatment exclusion criteria: * not applicable

Keywords: gall bladder cholecystectomy
comparison of pks of 17-beta-estradiol via sublingual placement versus swallowing in male-to-female transgender patients

Conditions: Gender Dysphoria

Summary: this crossover study will investigate the pharmacokinetics of oral versus sublingual administration of 17-beta-estradiol in the trans-female population.


Eligibility criteria:
inclusion criteria: * english speaker * currently taking 17-beta-estradiol tablet daily via sublingual or oral route on dose therapeutic for gender-affirming therapy; steady dose for at least 4 weeks * serum estradiol and testosterone levels within target therapeutic range (75-200 pg/ml and \<55 ng/dl, respectively) exclusion criteria: * active or history of deep venous thrombosis/pulmonary embolism * active or recent (within the past year) arterial thromboembolic disease (e.g., stroke, myocardial infarction) * liver dysfunction * history of breast cancer * history of orchiectomy * known sensitivity or allergy to any components of the study medication * taking potent cyp3a4 inhibitors or inducers

Keywords: estradiol gender-affirming estrogen
the effect of oral hypotonic hydration in isolated oligohydramnios

Conditions: Oligohydramnios

Summary: objective: the primary objective of our study is to compare the effects of routine hydration with additional 2 liters of normal water versus orally 2 liters of distilled water on the amount of amniotic fluid. hypothesis: i̇solated oligohydramnios, secondary to depleted maternal intravascular volume, can be reversed better with orally hypotonic water.

background: olygohydramniosis is a condition in which amniotic fluid levels are lower than expected for gestational age. it is typically diagnosed by ultrasound examination and may be described qualitatively (e.g., reduced amniotic fluid volume) or quantitatively (e.g., amniotic fluid index ≤5 cm, single deepest pocket \<2 cm). water hydration aims to decrease maternal osmolality and sodium concentration, increase water flow osmotically from maternal blood to fetal amniotic fluid, and improve uteroplacental perfusion. a meta-analysis comparing maternal hydration's effect reported that maternal intravenous hydration had good results on afi in pregnancies with isolated oligohydramnios and hypotonic solutions were more effective than isotonic fluids(1). maternal oral hydration may slightly increase amniotic fluid and is safer than intravenous fluid administration or amnioinfusion. reducing the osmolality in maternal blood with oral hypotonic and isotonic fluids helps to direct the placental water passage towards the fetus, to improve uteroplacental perfusion, and as a result, to increase the amount of amniotic fluid in pregnant women with isolated oligohydramnios. osmolality is further reduced by maternal oral hypotonic fluid, thus improving the amount of amniotic fluid. the study protocol was approved by the local ethics committee, and written informed consent will be taken from patients entering the study. the sample size was calculated based on the "maternal hydration increases amniotic fluid index" study of kilpatrick et al.(2). when 1.5 cm increase in afi is considered significant, with 90% power and type 2 error (alpha): 0.05, the sample size is 20 for each group, and it is planned to include 40 pregnant women in total. i

Eligibility criteria:
inclusion criteria: * singleton pregnancy * gestational age (ga) 28-39 weeks (based on the last menstrual period and confirmed by the results of ultrasound or determined through early pregnancy sonography) * isolated oligohydramnios cases * amniotic fluid index ≤ 5 * no pregnancy complications such as preeclampsia, gestational hypertension * intact fetal membranes. exclusion criteria: * presence of fetal complications (membrane rupture, presence of fetal anomaly, intrauterine growth restriction) * presence of maternal systemic disease (nephropathy, cardiac disease) * multiple pregnancies * conditions in which the amount of amniotic fluid cannot be accurately assessed (morbid obesity)

Keywords: oligohydramnios hydrotherapy hypotonic hydrotherapy
delayed positioning in cesarean section

Conditions: Hypotension

Summary: maternal hypotension is a common problem during cesarian section under spinal anesthesia. the possible explanation for this is combined aortocaval compression by gravid uterus in parturient in addition to reduced systemic vascular resistance by spinal anesthesia. the investigators evaluated if the incidence of hypotension would be decreased by delayed supine positioning, by maintaining lateral position for 6 min after spinal injection, in patients undergoing elective cesarean section.


Eligibility criteria:
inclusion criteria: * singleton parturients undergoing elective cesarean section * gestational age over 37 weeks exclusion criteria: * pregnancy with hypotension * expecting fetal depression